Choosing Your Quit Method: What the Evidence Says

There is no single best way to quit smoking, but there is a short list of methods with good evidence behind them. As of 27 October 2026, the Canadian Task Force on Preventive Health Care recommends that adults who smoke be encouraged to stop and be offered one or more proven options, chosen together with a health professional. Health Canada’s list is similar: counselling, a quitline, nicotine replacement therapy (NRT), prescription medicine, cytisine, or a mix.

What options are on the menu?

The Task Force’s 2025 guideline in CMAJ lays out a menu rather than a ranking. It includes combined behavioural and medicine approaches, brief advice from a provider, individual or group counselling, telephone counselling, mobile phone programs with a text-message component, self-help materials, and four medicines: bupropion, cytisine, NRT and varenicline. The guideline says people who smoke should take part in shared decision-making about which to use, and that what matters most is trying something shown to work.

Option	What it is	What the evidence says
Quitline or telephone counselling	Calls with a trained quit coach	A 2019 Cochrane review of 104 trials found moderate-certainty evidence that proactive telephone counselling helps people who call a quitline (risk ratio 1.38)
Text-message support	Automated texts during a quit attempt	A 2019 Cochrane review found moderate-certainty evidence that texting beats minimal support (risk ratio 1.54) and adds to other support (1.59)
Nicotine replacement (NRT)	Patch, gum, lozenge, inhaler, spray	A 2018 Cochrane review of 133 studies: risk ratio 1.55 against placebo or no NRT
Prescription medicine	Varenicline or bupropion, no nicotine	Named in the Task Force menu; a provider prescribes them
Cytisine	A natural health product, sold without a prescription	Named in the Task Force menu
Medicine plus counselling	Any of the above paired with behavioural support	A 2016 Cochrane review: risk ratio 1.83 against brief advice or usual care

A risk ratio of 1.5 means roughly half again as many people were still not smoking at follow-up as in the comparison group. It does not mean a 50 per cent personal chance.

Is combining methods better than picking one?

Often, yes. The 2016 Cochrane review found that pairing medicine with behavioural support increased quitting compared with brief advice, usual care or less intensive support. Health Canada makes the same point about NRT itself: using one form roughly doubles the chance of quitting, and combining a long-acting form with a short-acting one nearly triples it. The patch gives steady nicotine for up to 24 hours, while gum, lozenges, inhalers or sprays handle cravings as they arise.

The 2018 review also found that NRT’s benefit did not depend on how intensive the extra support was, so a person who wants medicine without sessions is not wasting it.

What if I want to quit without medicine?

That is a legitimate choice. Health Canada describes three routes: using a quit aid, cutting back gradually first, or quitting cold turkey, which works for some people but not everyone. Cutting back can mean skipping a cigarette, waiting 5 to 10 minutes before smoking, or delaying the first cigarette of the day by at least two hours. Health Canada also suggests picking a quit date no more than three weeks away, so you have time to prepare without losing momentum.

Support is still worth adding. Health Canada says counselling, one-on-one or in a group, can nearly double the chance of quitting, and quitlines are free. The national line is 1-866-366-3667, and free help by province shows what each province offers.

What about apps, online programs and vapes?

Cochrane found very low certainty evidence for smartphone apps (risk ratio 1.00). The Task Force conditionally recommends interactive online programs only when they include direct behavioural support, and conditionally recommends against them without it.

For vaping, Health Canada states that vaping products are not approved under the Food and Drugs Act as a quit-smoking aid, so they cannot be prescribed, and the Task Force suggests against e-cigarettes for quitting except in certain circumstances. If you have already switched, see how to quit vaping.

The Task Force also recommends strongly against St John’s Wort, S-adenosyl-L-methionine, hypnotherapy, acupuncture, laser therapy and electrostimulation for quitting smoking.

What should I ask a pharmacist?

Health Canada says pharmacists, doctors and nurses can advise on quit methods and refer you to other help. Questions worth bringing:

1. Which of these options are suited to my situation, and can they be combined?
2. Which products need a prescription and which do not? (NRT and cytisine can be bought without one; varenicline and bupropion cannot.)
3. How is my province or drug plan covering any of them? See medications to quit smoking in Canada and the pharmacy cessation programs page.
4. How long should I use it, and how do I stop?
5. I am pregnant, breastfeeding, under 18, or take other medicine. What changes?

On that last point, Health Canada advises people who are pregnant or breastfeeding to try counselling first, with short-acting NRT preferred over the patch if NRT is needed, and its quit planner says NRT is not recommended under 18 unless a doctor advises it. This page does not recommend a treatment or a dose.

What if the first choice does not work?

The Task Force notes that many people try several times with different interventions, and that people who relapse should go back to shared decision-making to find another option. Health Canada says each attempt is a step forward. See what to do after a slip and the first-week guide for the next steps.